Steep Drop in Circumcision in U.S.

A study by CDC researchers on rates of adverse events related to infant male circumcision in the United States has stirred debate on the Internet about the cultural and health values of the procedure.

Presented last month at the 18th International AIDS Conference, the retrospective study used hospital discharge data from SDI Health, the largest U.S. consolidator of electronic health care reimbursement claims. It found a low incidence of adverse events from neonatal male circumcision. While the study was not designed to analyze U.S. circumcision rates, the SDI data are being incorporated into the larger debate about male circumcision in the United States.

A slide from the study indicated that SDI data showed neonatal male circumcision rates falling from 56 percent in 2006 to 32.5 percent in 2009. The data do not include procedures outside of hospitals, such as Jewish ritual circumcisions, or circumcisions not covered by health insurance.

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"Word has gotten out that it's not necessary, it's harmful and it's painful," said Georganne Chapin, executive director of the New York-based non-profit Intact America. Increased attention to so-called female circumcision has also been a factor. "How can you think it's OK to cut little boys, when you are horrified by the idea of cutting little girls?" Chapin asked.

CDC was not involved in the collection of the data, "nor has CDC undertaken any review of this particular data for the purpose of calculating rates," said Elizabeth-Ann Chandler, an agency spokesperson. "As such, we cannot comment on the accuracy of this particular estimate of infant male circumcision."

CDC and the American Academy of Pediatrics are reviewing scientific data in advance of issuing new policy recommendations. AAP is likely to move from a neutral stance to a more encouraging one on circumcision, which has health benefits beyond HIV prevention, said Dr. Michael Brady, who served on the AAP task force.

Studies in Africa have shown male circumcision reduces the risk of female-to-male HIV transmission by up to 60 percent.

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